By Paul-Émile Cloutier

Stories of heroic and innovative efforts of healthcare workers toiling to the point of exhaustion across Canada to battle the COVID-19 pandemic may make for inspirational reading, but right now our healthcare system is teetering on the brink of a major health human resources crisis.

With wave four of COVID upon us, and threatening to get worse with winter coming, the voices from the frontlines of care are sounding more desperate than inspirational:

“No matter what brought you to our (emergency) department, we will try to help. We’ll continue to try to make things work. Because that’s what we do. But every day we work like this will cost us more skilled staff as they leave due to burnout.”
— Emergency Room physician, Saskatchewan

“It just kept getting worse and worse. I was having anxiety attacks where I would feel or be physically ill. I felt like I was going off to war or prison every day going into work.”
— Intensive care nurse, Ontario, as told to The Globe and Mail

“The current pandemic has hurled us towards a full-blown nursing crisis.”
— Linda Silas, President of the Canadian Federation of Nurses Unions

Healthcare is a people business. Having the right supply of qualified, resilient, and engaged healthcare workers is critical to ensuring high-quality care and the sustainability and continued evolution of our Canadian healthcare system. Further, with back-to-school, in-person learning upon us, a surge in demand for mental health services for children is likely to quickly overwhelm the system’s ability to respond.

The people who make healthcare work in Canada are suffering.  They themselves need care, but as for all Canadians, mental health services are in short supply with long queues. Our healthcare workers are also suffering because Canada has never had a national health strategy to ensure an adequate and sustainable workforce of physicians, nurses, other clinical professionals, administrative and support staff, volunteers, researchers, and learners. We already see the impact on access, quality, and efficiency of patient care. We also fear a corresponding impact on patient safety and health outcomes.

Working with our member leaders in healthcare and health research institutions across Canada, we have identified the top three health workforce priorities we believe the next federal government should engage in as a partner:

• Ensure an adequate supply of health human resources with the competencies, skills, and diversity required to sustain and evolve our healthcare system and equitably serve the diverse population and needs of Canada.
• Support the health, wellness, safety, and resilience of our workforce with a Pan-Canadian mental health strategy, tools, and resources for healthcare workers.
• Promote equity, diversity, inclusion, and reconciliation in our health system by addressing systemic discrimination, removing barriers, and developing talent within equity-seeking and underserved communities so that we reflect and serve all communities in Canada.

Early in the pandemic, governments and industry worldwide focused resources and extensive budgets to address challenges with personal protective equipment, medical equipment, and facility challenges with unprecedented speed. Yet as the pandemic has dragged on for the past 18 months it is healthcare workers who sustained the response, day in and day out, often at a personal cost to their own health and wellness.

Many healthcare workers delayed or came out of retirement, students stepped in, and thousands of retirees returned to the workforce to support their colleagues. This has caused a temporary increase in our workforce numbers as seen in CIHI’s recent report “Health workforce in Canada: Highlights of the impact of COVID-19”. However, as workers move (or return) to retirement, and others choose to leave healthcare, we will be relying on a diminished workforce facing increased public demands, risking an exponential rise in burnout, mental illness, and even death.

Also worrisome is the fact that we do not yet know the long-term effects of COVID on our workforce. With better mental health awareness, reduction in stigma and the introduction of presumptive legislation in many provinces, we anticipate an increase in claims for healthcare workers and first responders.

While this is more than concerning, we must ensure workers are both supported to seek care and have access to appropriate care is critical to their mental health and resilience and ultimately the sustainability of our workforce. Fundamentally, if we have learned nothing from this crisis, it is that more needs to be done to ensure healthcare workers have access to these services.

Canada’s COVID experience has shown yet again that our dedicated and skilled health workforce can respond in the face of relentless adversity. However, with wave four here we must urgently implement the lessons learned from the pandemic to support that workforce. We need ramp up the care we provide to our caregivers.

Paul-Émile Cloutier, President & CEO, HealthCareCAN